Concurrence Review

Establish a concurrence review process to double-read all high risk studies

The Radiology Quality Institute performed an analysis of all Radisphere practice errors over a five year period that were identified through its comprehensive peer review program to determine how errors were made, what studies have the greatest risk of errors, who was making the errors, and what could be done to lower error rates.

The RQI identified the studies that are the most complex and most likely to lead to a bad patient outcome if interpreted incorrectly. The analysis demonstrated that the studies with the highest errors included OB ultrasound, CT abdomen/pelvis, CT Chest, and CT Brain. CT errors by body part were: 51% abdomen; 22% brain; 11% spine; and 7.6% chest.

As a result of these findings, Radisphere implemented two initiatives to reduce the likelihood of error: risk alerts and proactive monitoring of high risk studies by a second radiologist. We “hard wired” risk alerts with “must not miss” guidance into our radiology information system to notify our radiologists when reading a high-risk study. We also automatically routed these high-risk studies for real-time concurrence review by a second radiologist. The concurrence interpreter is prompted to review the study for the exclusion of predetermined significant pathologies that should never be missed.

This structured, consistent approach helps detect and mitigate diagnostic errors before a patient’s treatment is adversely affected and contributes to the highly accurate interpretations that physicians expect from Radisphere radiologists.